In a study of National Cancer Database data reported in the Journal of Clinical Oncology, Neuman et al found that synchronous distant recurrence was identified in 27% of women with stage II or III breast cancer experiencing locoregional recurrence.

Patients who experienced locoregional recurrence within 5 years of diagnosis and those with synchronous distant metastases, defined as occurring within 30 days of locoregional recurrence, were identified.

Distant Recurrence

Overall, locoregional recurrence occurred in 445 patients (4%). Synchronous distant metastases were identified in 120 (27%) of these patients. An additional 1,305 patients experienced distant recurrence without local recurrence during the study period.

The investigators concluded, “These findings support current recommendations for systemic imaging in the setting of locoregional recurrence, particularly for patients with lymph node or chest wall recurrences. Because most patients with isolated locoregional recurrence will be recommended locoregional treatment, early identification of distant metastases through routine systemic imaging may spare them treatments unlikely to extend their survival.”

The study was supported by the Patient-Centered Outcomes Research Institute, National Cancer Institute, and National Institutes of Health.